The Anomalous Wellbeing of Disabled People: A Response

Disabled people frequently find themselves in situations where their quality of life and wellbeing is being measured or judged by others, whether in decisions about health care provision or assessments for social supports. Recent debates about wellbeing and how it might be assessed (through subjective and/or objective measures) have prompted a renewed focus on disabled people’s wellbeing because of its seemingly ‘anomalous’ nature; that is, whilst to external (objective) observers the wellbeing of disabled people appears poor, based on subjective assessments, people with disabilities report a good quality of life. In this paper, I examine an article by the philosopher Dan Moller in which he seeks to explain this ‘disability paradox’. Despite agreeing with his analysis that there is more to what people value than happiness, his explanation reflects some of the difficulties presented in philosophical accounts which seek to understand the lives of disabled people: this includes an analysis which fails to problematise definitions of wellbeing and who has the ‘voice’ to do the defining; which negates the multiple identities and subject positions that disabled people occupy; and which lacks recognition of the social contexts which mediate disabled people’s lives. I suggest that there is a need to incorporate disabled people’s voices into research which deepens our empirical knowledge about the relationship between impairment and wellbeing, including the social circumstances that shape disabled people’s agency.     

Listening to Somatosensory States in Psychoanalysis: Body,Trauma, and Poetry

ABSTRACT

The author starts from the apparently outdated James-Lange theory of emotion to rediscover elements of modernity for contemporary psychoanalysis: from James’ bodily-sensory dimension to Damasio’s “feeling of what happens,” to Bucci’s attention to the patient’s visceral narrative in session. William James stated that bodily sensations are the first elements on the path toward consciousness. Damasio emphasizes that “Consciousness is rooted in the representation of the body”. Bucci presents a framework for identifying linkages between bodily and symbolic states and to observe the various degrees of patients’ “visceral speech” in session. These parallels support a sensibility to listen to language as the voice of the body: the relationship between the patient’s narrative and the bodily-sensory dimension can be grasped through the patient’s “imagery” which may reference earlier somatic experience. Particular emphasis is given to the story-telling of trauma.     

The effects of patient's frequency of attendance and etiology of symptoms,on the General Practitioners wellbeing

IntroductionThe presence of Medically Unexplained Symptoms and a high Frequency of Attendance negatively affects the General Practitioners’ (GP) wellbeing. Although, overlapping between both phenomena is partial, with a number of frequent attenders reporting medically unexplained symptoms during consultation, there is no evidence on how GP's well-being it is affected by the specific main effects of these factors and their interaction. Evidence is also scant on the psychological processes explaining the negative impact of attendance and the etiology of symptoms on GP's wellbeing.ObjectiveDrawing on the Job Demand-Control and the Conservation of Resource stress models, this paper tests the moderating effects of the GP’ perception of patient's attendance and etiology of symptoms on the relationship between patient's demands and feedback on the GP's wellbeing.MethodA total of 105 volunteer GPs self-reported on the study variables through an experience sampling methodology after 898 patients’ consultation. Patients attendance and etiology of symptoms were categorized according to the physician self-perception and an external criterion (organizational records).ResultsPerception of Patients Frequent Attendance and Medically Unexplained Symptoms were positively related to physician's Emotional Exhaustion. Contrary to expected the test of the moderation effects of patients characteristics on the relation between patient's demands and feedback and the GP's emotional exhaustion were stronger for normal attenders compared with frequent attenders. An ad hoc study shows this unexplained result is related to the GP's expectations on Frequent vs. normal attenders’ behaviors. No significant results were found when the external criterion of classification was used.ConclusionCombined analysis of Frequency of Attendance and Etiology of Symptoms lead to a better understanding of the GP's decreased wellbeing. Also, the perception of the strain level (demands/positive feedback levels) associated to the consultation with different types of patients contribute to explain the consequences for the GP's wellbeing, especially when GP's expectations on patient's behaviors are violated.     

Is children’s wellbeing different from adults’ wellbeing?

ABSTRACT

Call generalism about children’s and adults’ wellbeing the thesis that the same theory of wellbeing applies to both children and adults. Our goal is to examine whether generalism is true. While this question has not received much attention in the past, it has recently been suggested that generalism is likely to be false and that we need to elaborate different theories of children’s and adults’ wellbeing. In this paper, we defend generalism against the main objections it faces and make a positive case for it.     

Making good choices: toward a theory of well-being in medicine

The principle of beneficence directs healthcare practitioners to promote patients’ well-being, ensuring that the patients’ best interests guide treatment decisions. Because there are a number of distinct theories of well-being that could lead to different conclusions about the patient’s good, a careful consideration of which account is best suited for use in the medical context is needed. While there has been some discussion of the differences between subjective and objective theories of well-being within the bioethics literature, less attention has been given to the questions of what work a theory of well-being needs to do in bioethics and which standards of success ought to be used in selecting a theory of well-being for use in medicine. In this article, I argue that traditional theories of well-being developed in philosophy are not well suited to meet the needs of the medical context. For the principle of beneficence to be most useful, the underlying account of well-being should satisfy two conditions: first, it needs to lead to a concrete, action-guiding determination of the patient’s good; and, second, any recommendations it offers need to be justifiable to patients. Standard accounts of well-being have difficulty satisfying both conditions. Exploring the limitations of these theories when applied to treatment dilemmas helps point the way toward the development of an account of well-being better suited to healthcare.     

The pedagogical imperative of values education

Recent research has exposed the potential of quality teaching to exercise a positive influence on student achievement. Extending beyond surface and factual learning, quality teaching has posited conceptions of ‘intellectual depth’, ‘communicative competence’ and ‘self‐reflection’ as being central to effective learning. Implicit in these conceptions are values dimensions reflected in notions of positive relationships, the centrality of student welfare, school coherence, ambience and organisation. The influences of these on student learning, welfare and progress have been observed across public, private and religious sectors, thus confirming earlier studies of similar phenomena in religious schools. Evidence from the Australian Government's Values Education Good Practice Schools Project indicates the benefit to all schools of reflecting on, re‐evaluating and rethinking the implications of values education for curricula, classroom management and school ethos in the interests of student wellbeing and progress. This indicates a pedagogical imperative for values education which extends beyond boundaries of personal or systemic interests and ideologies.     

Why ‘Nonexistent People’ Do Not Have Zero Wellbeing but No Wellbeing at All

Some believe that the harm or benefit of existence is assessed by comparing a person's actual state of wellbeing with the level of wellbeing they would have had had they never existed. This approach relies on ascribing a state or level of wellbeing to ‘nonexistent people’, which seems a peculiar practice: how can we attribute wellbeing to a ‘nonexistent person'? To explain away this oddity, some have argued that because no properties of wellbeing can be attributed to ‘nonexistent people’ such people may be ascribed a neutral or zero level of wellbeing, setting the baseline for comparatively assessing the harm or benefit of coming into existence. However, this line of argumentation conflates the category of having zero wellbeing with the category of having no wellbeing. No Φ, unlike a zero level of Φ, is not comparable to levels of Φ — neutral, positive, or negative. Considering the nature of wellbeing and the fact that ‘nonexistent people’ cannot (metaphysically or conceptually) have wellbeing determinative properties, it follows that ‘nonexistent people’ have no wellbeing rather than zero wellbeing.     

The Spatiality of Pain

Abstract

My remarks on Metz’s project will focus on another angle than the one Metz uses. I am more interested in thinking about whether and how far ethical standards from different cultures really differ, how to understand those differences, and how to relate them to what is objectively good, independently of people’s opinions on the matter. Of course one widely circulating opinion on the topic is that cross-cultural differences somehow demonstrate that there is no such thing as objective good at all - that each culture has its own conception of what is good, right, permitted, forbidden, and so on, and the differences are so wide that anyone at all familiar with this, can no longer take seriously the idea that there could be any “objective” values underlying such varied systems.     

Oliva Sabuco de Nantes and her Nueva Filosofia: a new philosophy of human nature and the interaction between mind and body

ABSTRACT

The main objective of the New Philosophy was to ‘improve the lives of people and nations in part by improving medical practice’. To this end, Oliva Sabuco sought to improve humankind's knowledge of the philosophical underpinnings of medicine while taking experiential practices into account. She suggested that a variety of procedures (pharmaceutical, emotional and therapeutic) should be adopted to maintain and restore harmony between the mind and body. Oliva Sabuco sought to promote health and prevent disease by expanding our knowledge of the interrelationship between mind and body; the ultimate goal was to understand the body's function and form in order to promote inner harmony and thus health. The influence of classical traditions in moral and natural philosophy, medicine, and cosmography is unmistakable in Oliva Sabuco's text, yet she synthesized these traditions, disagreed with fundamental aspects of them, and transformed them in a holistic philosophy of human nature that is part of a larger view of the cosmos and mankind's place in it.     

Exile and return: from phenomenology to naturalism (and back again)

Abstract

Naturalism in twentieth century philosophy is founded on the rejection of ‘first philosophy’, as can be seen in Quine’s rejection of what he calls ‘cosmic exile’. Husserl’s transcendental phenomenology falls within the scope of what naturalism rejects, but I argue that the opposition between phenomenology and naturalism is less straightforward than it appears. This is so not because transcendental phenomenology does not involve a problematic form of exile, but because naturalism, in its recoil from transcendental philosophy, creates a new form of exile, what I call in the paper ‘exile from within’. These different forms of exile are the result of shared epistemological aspirations, which, if set aside, leave open the possibility of phenomenology without exile. In the conclusion of the paper, I appeal to Merleau-Ponty as an example of what phenomenology without epistemology might look like.     

Critique of Sharif’s and Pitt’s Models of Technology

abstract

In this article Pitt’s and Sharif’s models of technology are discussed. These models are based on two different conceptions of technology, which are technology as “instrument” and as “making use of instrument.” Sharif considers technology as a collection of empowering tools, including technoware, humanware, infoware and orgaware. On the other hand, Pitt sees technology as “humanity at work.” Based on his definition, Pitt proposes a model of technology with three components; first-order transformation, second-order transformation, and the assessment of feedback mechanism. In this article this model will be explained and criticized. After that, Sharif’s model is criticized in the light of Pitt’s theory and it will be shown that Pitt’s model provides a better understanding of different aspects of technology. For example, it will be argued how Pitt’s model is efficient in explaining dynamicity, transfer and control of technology along with its soft dimensions, while Sharif’s model is incapable of doing so. In the next part, Pitt’s model is criticized and it is shown that the mechanism of knowledge progress suggested by this model is controversial and Pitt’s framework cannot support the idea of indigenous technology. Furthermore, the ability of Pitt’s model in describing different technological phenomena is called into question, since this model provides a superficial view of the complexity of an assessment of technology’s consequences. Finally, a list is proposed that contains minimal requirements that every model of technology is expected to explain. It is incumbent on technology theoreticians to consider this list.     

Conservation of Mass,Weight, and Volume as Evidenced by Adolescent Girls in Eighth Grade

Summary

This investigation is a replication of part of a study by Elkind on quantity conceptions in adolescence. A home economics class composed of 28 eighth-grade girls in a junior high school in Levittown, New York, were tested with Piagetian tasks to determine their conceptions of mass, weight, and volume. The results are strikingly parallel to those obtained by Elkind for the same mean age group. In both studies, only 29% of the subjects of mean age 13.6 had attained the conception of conservation of volume, a finding at variance with Piaget's earlier results.     

The Objectivity of Wellbeing

Subjective theories of wellbeing place authority concerning what benefits a person with that person herself, or limit wellbeing to psychological states. But how well off we are seems to depend on two different concerns, how well we are doing and how well things are going for us. I argue that two powerful subjective theories fail to adequately account for this and that principled arguments favoring subjectivism are unsound and poorly motivated. In the absence of more compelling evidence that how things go for us cannot directly constitute our wellbeing, I conclude that wellbeing is objective.     

Reply to critics

ABSTRACT

In this reply to critics, I reply to Stephanie Leary’s, Kris McDaniel’s, Tristram McPherson’s and David Plunkett’s articles on my book Choosing Normative Concepts. One central theme in the replies concerns what is the best strategy for the so-called ardent realist when it comes to responding to the challenge I present in the book. Another central theme concerns the criticisms of my characterizations of what normative concepts and normative properties are.     

Judging the quality of qualitative inquiry: Criteriology and relativism in action

Statement of problemA variety of conceptions of qualitative research exist. This leads to a situation in which there are competing claims as to what counts as good-quality work. These competing claims revolve around the issue of criteria and how they are used to pass judgment on qualitative research. Those involved in sport and exercise sciences need to reflect on this issue with a view to generating further dialogue and a greater understanding of difference within the research community.MethodTwo ideal types of researcher, one a criteriologist the other a relativist, are constructed to illustrate how each might judge qualitative studies of different kinds.ResultsA comparison of the ways in which the criteriologist and the relativist draw on different assumptions to judge qualitative studies illustrates the constraining nature of the former and the expansive possibilities of the latter.ConclusionsCriteria should be viewed as lists of characterizing traits that are open to reinterpretation as times, conditions, and purposes change. Researchers need to adopt the role of connoisseur in order to pass judgment on different kinds of study in a fair and ethical manner.     

<Emphasis Type="Italic">Justice for Hedgehogs</Emphasis>, Conceptual Authenticity for Foxes: Ronald Dworkin on Value Conflicts

In his 2011 book Justice for Hedgehogs, Ronald Dworkin makes a case for the view that genuine values cannot conflict and, moreover, that they are necessarily mutually supportive. I argue that by prioritizing coherence over the conceptual authenticity of values, Dworkin’s ‘interpretivist’ view risks neglecting what we care about in these values. I first determine Dworkin’s position on the monism/pluralism debate and identify the scope of his argument, arguing that despite his self-declared monism, he is in fact a pluralist, but unusual in denying conflict between plural values. I then set out the structure of his interpretive theory of value relations and present a case of value conflict which I think interpretivism cannot deal with. Following this I argue that there are structural reasons why cases like this are liable to occur and suggest that interpretivism will frequently fail to properly reflect people’s moral commitments because reinterpretation of values has the side effect of excluding important moral commitments from our conceptions of values. While, as Dworkin argues, there are no brute moral facts concerning values, moral psychology constrains the range of acceptable conceptions of values. Given the shortcomings of interpretivism I conclude that we should acknowledge that values may conflict.     

Bioinspired decision-making for a socially interactive robot

Nowadays, robots and humans coexist in real settings where robots need to interact autonomously making their own decisions. Many applications require that robots adapt their behavior to different users and remember each user’s preferences to engage them in the interaction. To this end, we propose a decision making system for social robots that drives their actions taking into account the user and the robot’s state. This system is based on bio-inspired concepts, such as motivations, drives and wellbeing, that facilitate the rise of natural behaviors to ease the acceptance of the robot by the users. The system has been designed to promote the human-robot interaction by using drives and motivations related with social aspects, such as the users’ satisfaction or the need of social interaction. Furthermore, the changes of state produced by the users’ exogenous actions have been modeled as transitional states that are considered when the next robot’s action has to be selected. Our system has been evaluated considering two different user profiles. In the proposed system, user’s preferences are considered and alter the homeostatic process that controls the decision making system. As a result, using reinforcement learning algorithms and considering the robot’s wellbeing as the reward function, the social robot Mini has learned from scratch two different policies of action, one for each user, that fit the users’ preferences. The robot learned behaviors that maximize its wellbeing as well as keep the users engaged in the interactions.     

D. Z. Phillips and reasonable belief

As an illustration of what Phillips called the “heterogeneity of sense,” this essay concentrates on differences in what is meant by a “reason for belief.” Sometimes saying that a belief is reasonable simply commends the belief’s unquestioned acceptance as a part of what we understand as a sensible outlook. Here the standard picture of justifying truth claims on evidential grounds breaks down; and it also breaks down in cases of fundamental moral and religious disagreement, where the basic beliefs that we hold affect our conception of what counts as a reliable ground of judgment. Phillips accepts the resultant variations in our conceptions of rational judgment as a part of logic, just as Wittgenstein did. All objective means of determining the truth or falsity of an assertion presume some underlying conceptual agreement about what counts as good judgment. This means that the possibility of objective justification is limited. But no pernicious relativism results from this view, for as Wittgenstein said, “After reason comes persuasion.” There is, moreover, a non-objective criterion of sorts in the moral and religious requirement that one be able to live with one’s commitments. In such cases, good judgment is still possible, but it differs markedly from the standard model of making rational inferences.     

Inter-State Internal Migration: State-level Wellbeing as a Cause

The relationship between subjective wellbeing and in-migration is explored in this paper. The wellbeing of a state is considered an incentive for in-migration to that state as the wellbeing in that state increases. A cross-sectional, multiple regression on the contiguous states in the United States was used to determine if there is any relationship. A significant and positive relationship was found between state-level subjective wellbeing and net in-migration when controlling for economic and non-economic variables typically associated with in-migration. The positive relationship indicates that as a state’s wellbeing increases its appeal as a destination for internal migrants increases as well. It is recommended for policymakers to focus on improving the subjective wellbeing of their state’s residents not only to retain and attract new residents, but as a general measure of successful administration. Future studies are needed to verify the link between a state’s wellbeing and in-migration to that state. This study serves as a first step in this literature.